title: Influence of retirement on nonadherence to medication for hypertension and diabetes.
abstract: BACKGROUND
  The extent to which common life transitions influence medication adherence among patients remains unknown. We examined whether retirement is associated with a change in adherence to medication in patients with hypertension or type 2 diabetes.
  
  
  METHODS
  Participants in the Finnish Public Sector study were linked to national registers. We included data for the years 1994-2011. We identified and followed 3468 adult patients with hypertension and 412 adult patients with type 2 diabetes for medication adherence for the 3 years before their retirement and the 4 years after their retirement (mean follow-up 6.8 yr). Our primary outcome was proportion of patients with poor adherence to medication, which we defined as less than 40% of days covered by treatment. We determined these proportions before and after retirement using data from filled prescriptions.
  
  
  RESULTS
  The preretirement prevalence of poor adherence to medication was 6% in men and women with hypertension, 2% in men with diabetes and 4% in women with diabetes. Among men, retirement was associated with an increased risk of poor adherence to both antihypertensive agents (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.03-1.68) and antidiabetic drugs (OR 2.40, 95% CI 1.37-4.20). Among women, an increased risk of poor adherence was seen only for antihypertensive agents (OR 1.25, 95% CI 1.07-1.46). Similar results were apparent for alternative definitions of poor adherence. Our results did not differ across strata of age, socioeconomic status or comorbidity.
  
  
  CONCLUSIONS
  We found a decline in adherence to medication after retirement among men and women with hypertension and men with type 2 diabetes. If these findings can be confirmed, we need randomized controlled trials to determine whether interventions to reduce poor adherence after retirement could improve clinical outcomes of treatments for hypertension and diabetes.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: G David
authors.initials: GD
authors.lastname: Batty
authors.forename: Mark
authors.initials: M
authors.lastname: Hamer
authors.forename: Hermann
authors.initials: H
authors.lastname: Nabi
authors.forename: Maarit
authors.initials: M
authors.lastname: Korhonen
authors.forename: Risto
authors.initials: R
authors.lastname: Huupponen
authors.forename: Jaana
authors.initials: J
authors.lastname: Pentti
authors.forename: Tuula
authors.initials: T
authors.lastname: Oksanen
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.forename: Hugo
authors.initials: H
authors.lastname: Westerlund
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010349:Patient Compliance; D012042:Registries; D012179:Retirement; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents